Breathe Like a Baby

Often times teaching people some of the most basic movements can be the most challenging.  A case in point is breathing.

Movements that are so basic that they were mastered in the early stages of development can become dysfunctional for myriad reasons, including pain, injury, poor posture, and impaired movement.  The diaphragm is part of our core, whose main purpose is to help reflexively stabilize our spines so that we can function well without injury.  When the core isn't performing optimally, you may be setting yourself up for increased risk of injury.  But how do you know if you have issues with your core?  Let's start with the most essential movement, breathing.

Take a look at this clip of my 2 month old son, Bennett:

Notice how his belly flares out while his rib cage doesn't move very much.  Do you breathe like that?  Try this simple move.  Lie on your back and place one hand on your belly, the other on your chest.  Breathe by inhaling through your nose and exhaling through pursed lips, as if blowing up a balloon.  Focus on making your belly hand rise on inhalation while your chest hand remains relatively still.  Seems simple, right?  You'd be amazed at how folks struggle with this in the clinic.  And usually their first reaction is, "I had no idea how I was breathing in the first place!"

Those who come into my clinic with complaints of upper back, neck and shoulder pain often struggle with breathing correctly.  They're the "high anxiety" breathers who use muscles which are not intended to do the heavy lifting of breathing to compensate for their diaphragm.  They have a difficult time "quieting down" their ribcage during the above exercise.  But they are not the only ones who will benefit from re-learning how to breathe correctly.  Everything we do in life benefits from correct breathing.  And while simply breathing correctly isn't the cure-all for pain, it certainly plays a vital role in good functional movement.  In addition, an inability to breathe diaphragmatically can be an indication of impaired core motor control, which carries with it potentially broader implications.

Before you can begin to correct the way you move, you must first become aware of how you are moving in the first place.  So try this simple breathing exercise.  You may find that something "so easy that a baby can do it" is more challenging than you think.

What's Your Favorite Television Show?

I was having a conversation with a patient about the frequently heard excuse as to why people don't exercise on a regular basis, which is that they don't have the time.

"That's a bunch of crap," he said.  "I guarantee you I have a busier life than 90% of your patients."

My first thought was that that was a fairly bold and presumptuous statement for somebody to make. After all, how can he know what other people's lives are like?  But then he explained that in addition to being a partner at his law firm (time consuming), he was a single father of three (very time consuming), one of whom has special needs (unimaginably time consuming and emotionally exhausting).  Maybe he was right after all.

After sharing the details of his jam-packed life, he then said to me something that resonated and stuck with me:

"The next time one of your patients says to you that they don't have time to do their exercises, ask them 'What's your favorite T.V. show?'  If they have one, then the have time for exercise."

Look, I know that people don't want to be preached to about the importance of exercise.  It gets annoying.  But I DO think it's that important, and it's why I continue to write about it.  I'm also not sitting on some high-horse saying that I don't enjoy some good mindless television watching.  After all, I watch episodes of Seinfeld that I've already seen 8 times and still laugh (which also has value)!  I watch my fair share of Knick, Giant, and Yankee games.  I even watched American Idol with my wife until this year (yes, I admit it).  I'm simply saying that if we truly examined our days and were more honest with ourselves, squeezing in a little bit of exercise would suddenly seem a lot more feasible.

Not long ago I read a quote from a doctor who said that if an obese person comes into his office, the single best thing that he could do to help all of their impaired systems would be to take them for a walk.  But he can't, because that's not how our healthcare system works.  So instead he prescribes medication and performs reactionary procedures.  With that thought in mind, the next time you sit down to watch Dr. Oz's show about ways to stay healthy, try turning the set off, grab an apple, and go for a walk.  Rather than sitting for an hour watching a TV doctor talk about how to get healthy, you'll be using that newly discovered hour to actually DO SOMETHING to get healthy.  It's a notion to which Dr. Oz himself, if not his advertising sponsors, should surely agree.

Perfuse It or Lose It

We all know the physical benefits of regular exercise.  But what about what it does for our brains?

A few years ago when I was working for the New York City Department of Education, I attended a workshop on the topic of yoga for special needs students.  I recall a simple study that tested children's motor skills pre- and post-exercise.  The children had to draw as many marks as they could within a minute, keeping each mark within two lines spaced an inch apart.  Then they stood up and performed a simple form of exercise (I believe it was jumping jacks) for 60 seconds before sitting down and repeating the task.  The results showed that post-exercise, the children consistently performed better by drawing more lines with greater accuracy.

Last week I read an article entitled "Sitting is the New Smoking".  I found that statement to be a bit hyperobolic, but one thing that I completely agreed with was the author's newfound habit of conducting as many "walking" business meetings as possible.  I think that's a fantastic idea.  Who says that every meeting has to be around a conference table, with stale bagels and Danish off in he corner?  Why not go for a 30 minute walk around the neighborhood to discuss business matters?  One common reason why folks say they don't exercise on a regular basis is because they don't have time.  What better way to get it in than to work it into your regular day?  If I were the CEO of some company, I would strongly encourage my employees to take a two hour lunch to get some exercise (and food) in the middle of the day.  I KNOW they would be more productive in the afternoon.  After all, I'd rather have a clear-headed employee log three useful hours in the afternoon than a post-lunch groggy employee spend five sluggish hours warming their seat.  What good does that do anyone?  Employee moods, morale, and efficiency would all surely improve.  I'm even willing to bet that absenteeism would drop because people would be healthier overall.

Typically one of the first programs to get cut in schools on tight budgets are gym classes.  This is stupid and short sighted.  If we truly want our kids to be more alert, think more clearly, be more productive, and perform better in every other facet of their lives, we should be INCREASING opportunities to move, NOT DECREASING them!

Perfusing the brain with more blood, oxygen and nutrients helps us think better.  It's why we exercise to "clear our heads".  And it's what happened to me this morning on my run as this topic came to mind.  So, next time you go to break a sweat, think about the good you'll be doing for your head as well as your body.  Who knows, perhaps it will be the catalyst for your next million dollar idea.

THAT'S What It's About!

Today a patient whom I've been seeing for low back pain told me that she "tweaked" her back when she misstepped while shopping last week.  But then she added the following:

"You know, I didn't worry so much about it when I re-injured my back.  This time, I knew what to do and was able to calm the pain down with the things you taught me.  As a result, it's feeling so much better today."

That was music to my ears!!  In my opinion, that's what physical therapy is ALL about.  We're here to teach YOU how to take care of YOURSELF.  As soon as someone is able to shift the focus of their rehabilitation from one of dependency to one of central control, then true success can be achieved.  I consider myself first and foremost a teacher in many ways.  Yes, there are certainly passive techniques and interventions that I use to help people with painful dysfunction.  But for me, the best part of my job is when people learn to take ownership of their physical well-being.

In a weird way, I'm in the practice of putting myself out of business.  So are all health care practitioners.  After all, the fewer times that someone "needs" to come see me for my services, the less I get paid.  But I'm alright with that, as long as it means my patients are getting better faster, and staying healthy longer.  So when I hear a comment like the one above, my day is made, because that's what it's all about.

Learn to take your health into your own hands.  It's an incredibly powerful tool that will leave you relying less on medicines and health care practitioners, and more on yourself.  After all, who should care more about you than you?